Fall 2015

The Pacific Vision Foundation Newsletter

With a mission of preventing blindness and improving vision for those who see imperfectly, excellence in patient care is at the heart of Pacific Vision Foundation’s decision to create a regional center of excellence in vision care. Patients benefit from the advantage of being treated by physicians who consult, collaborate, teach and work together.

The stories on these pages are typical of how individuals come from near and far to receive the specialist care they need and how the physicians affiliated with the future Eye Institute are already working together to change lives.

Realizing an Artistic Vision

For Ginny Doyle (above), an artist whose paintings have been exhibited from Beijing to New York to Paris, the process of losing her vision actually fostered new forms of visual expression. Describing her condition like “driving on the Golden Gate Bridge in thick fog,” she has been under-going treatments for Macular Degeneration for over 5 years. She is able to continue creating art thanks to injections she receives every 6 weeks from Dr. Arthur Fu (next page) at the

Improving Patients’ Lives at the Heart of PVF’s Care–The Gift of Sight is Priceless

ALSO IN THE

FALL 2015 ISSUE:

2: Bringing “Amazing” Clarity 3: The Present of Safety; A World-Expanding Alignment4: Reconstructing More than Just an Eye5: Vision Facts: Ocular Shingles Raises Stroke Risk

5: Alumni Abroad, Dr. Vincent Ray6: New Board Member—Ellen Jamason7 : Visionary Leadership—Poised for a Strong Future8: Giving Opportunities—Why Your Support Matters

American Academy of Ophthalmology Honors Dr. Bruce Spivey with 2015 Laureate Recognition AwardPVF Chairman Dr. Bruce Spivey (below) has won many awards over his brilliant career as an educator, physician and leader, but his latest – the 2015 Laureate Recognition Award from the over 30,000 members of the American Academy of Ophthalmology (AAO) – stands at the top.

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(continued from page 1) West Coast Retina Group. “I know that injections in the eye sound pretty horrifying,” she admits, but “Dr. Fu does them very smoothly and it’s really not painful.”

She remembers buying drugstore reading glasses with progressively stronger lens before finally making an appointment with San Francisco Ophthalmologist Dr. Gary Aguilar, who insisted that she see a retina specialist immediately, phoning for her appointment himself. Today she is most grateful for his referral. Doctors Aguilar and Fu are colleagues in the Department of Ophthalmology at California Pacific Medical Center.

According to Dr. Fu, wet macular degeneration results from abnormal bleeding in vessels underneath the retina and if untreated, the retina becomes scarred and cannot be repaired. For patients who receive an early diagnosis and treatment, damage can be halted through periodic injections.

Before Ginny’s vision problems, she painted detailed figure studies and landscapes, and today, as a result of this challenge, she has developed more abstract expressionist types of paintings that tapped into her new feelings of

coping with life. “One of the paintings I’m most proud of is called ‘Balance’ in which a man is dancing inside a nest. It’s always been my metaphor for home: your sense of being and who you are. The man is trying to grab at something that’s falling apart.”

“Losing my sight was scary at first, but expressing fear in my painting has helped me feel less afraid,” Ginny said. As part of her success story, “Balance” won the big prize at a juried exhibition of blind artists’ works in Chicago sponsored by Second Sense, a non-profit that helps artists cope with vision loss.

Ginny said that doing her art is “a lot more fun now. I’m achieving goals that I couldn’t achieve before, and people are buying more of my art than ever before.” Dr. Fu continues to provide injections every six weeks, and she can still realize her vision artistically.

Dr. Fu, who serves as Chief of the Retina service at California Pacific Medi-cal Center volunteers at the Lions Eye Clinic teaching residents and treating patients, says that the clinical trials con-ducted by his office permit experimental treatments that create new options for people with impaired vision. He enjoys having the chance to form a relationship with patients who see him frequently. “Ginny Doyle is really impressive,” he says, “just like Matisse who worked with scissors and colored paper when he couldn’t stand at an easel, Ginny has learned to accommodate her style.”

Bringing ‘Amazing’ Clarity

Karl Kuhlmann (above right), a software engineer, was creating programs that interpret scientific data from DNA sequences when in September 2011, the complex strings of code on his computer monitor started getting blurry. “By December, my eyes had gotten so bad that I could only read code by

supersizing the font,” recalled Karl, who lives in Menlo Park, California. “I also stopped driving because I had trouble seeing street signs. That’s when I realized there was something seriously wrong.”

After a diagnosis of Fuchs Corneal Dystrophy, a genetic condition affecting the endothelial cells of the cornea, he was referred to Dr. Margaret Liu (below), Chief of Cornea, at California Pacific Medical Center. Dr. Liu performed a type of corneal transplant surgery called a Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) on Karl’s left eye. “The surgery was very successful,” she said, “but tragically, his wife passed away and we lost touch for almost a year.“

When Karl returned for a followup visit, he had developed glaucoma in his left eye, and symptoms of Fuchs

Realizing an Artistic Vision

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Dystrophy in his right eye. Dr. Liu provided treatment that stabilized the glaucoma, and in January 2015 performed an even thinner donor cornea graft procedure on his right eye. This technique, a Descemet’s Membrane Endothelial Keratoplasty (DMEK), uses a graft that is just 15 microns thin and has the advantage of faster visual recovery and shorter durations of high-dose topical steroids.

The result “is a lifesaver,” he said. “I can’t get over how much better my eyes are. I’ve worn glasses since I was eight, and don’t remember when I could see this well. I can read everything now, even the words on my smartphone without enlarging them. And I passed my driver’s test without glasses.”

Dr. Liu said that vision improve-ments resulting from corneal transplant procedures are often quite dramatic, and Karl’s case was no exception. He was so grateful that he was inspired to write lyrics to the tune of “Amazing Grace”:

Amazing Peg, how sweet the thingsthat Doctor Liu can doI once was blind but now I seeall thanks to Margaret Liu.

Receiving the Present of Safety

For nearly a decade, Jeanie Mohan (above) suffered from a blocked tear duct

on her right eye. “I would be working in the garden or doing something else,” the retired math teacher explained, “when suddenly a huge drop of water would fall down my face.”

While it was annoying, Jeanie was apprehensive about having a delicate eye operation yet consulted with Dr. Stuart Seiff, an oculofacial plastic surgeon at California Pacific Medical Center. In less than an hour using local anesthetic, he created a new drainage tract from Jeanie’s tear duct to her nasal cavity—and with no visible scar. “It was absolutely amazing,” she said.

Meanwhile, another longtime condition was limiting her vision—she had cataracts in both eyes coupled with a moderate amount of astigmatism, a common condition caused by eyes that are more oval than round. The greatest impact, besides nearsightedness, was difficulty driving at night because cataracts clouded the lens of her eyes, making vision blurry.

Dr. Kevin Denny (above), Chair of Ophthalmology at CPMC, conducted careful tests to evaluate the amount and orientation of her astigmatism, and the results demonstrated that she was a good candidate for lens implants (called Toric Lenses) that would neutralize most of that condition. In the spring of 2015,

he performed cataract surgery in her left eye, which went well, and followed it two months later with surgery to remove the cataract on her right eye.

“Her surgeries were a big success because she sees much better, both with and without glasses,” Denny added. “She feels more comfortable driving, especially at night, and her chronic tearing to which she had become resigned was resolved.” This great result required careful evaluation, consulting among physicians with different skills and formulating a plan “that is consistent with the patient’s needs and goals learned from extended conversations over time,” Denny explained, adding, “About thirty to forty percent of cataract patients will benefit from a Toric Lens. When combined with removing cataracts, it really clears up people’s vision, and it’s very gratifying to help restore people’s sight in such a dramatic way.”

According to Jeanie Mohan, it’s “like getting a present every single day. Being able to drive safely and walk without worrying about tripping makes me confident and younger. I feel so grateful to both of them every single day for everything they did.”

A World-Expanding Alignment

Alberto Consuelo (above) was born with strabismus, sometimes referred to

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as cross-eyed” or “wall-eyed,” but as a youngster in Mexico he did not have access to physicians who could correct this misalignment. “I had a hard time as a kid, because people made fun of my lazy eye,” he lamented. “When I got older, people didn’t want to hire me because of how I looked. Living with this disability was very difficult because people treated me differently, and that made me very self-conscious.”

Although Consuelo moved to San Diego at age 12, it wasn’t until he was older and living in Alameda, California, that a physician in an Oakland clinic told him that surgery could straighten his eye. Soon he had an appointment with Dr. Taliva Martin (above), a pediatric ophthalmologist and adult strabismus specialist who enjoys the challenges and rewards of helping adult strabismus pa-tients. “Too many adults live their entire lives unhappy with their appearance, hesitant to make eye contact and interact socially due to ocular misalignment,” she said. “It can have a significant negative impact on their lives and careers. Recon-structive procedures in these cases can be life-changing.”

About 5% of children in the US are affected by strabismus, but up to 50%-90% of children with associated conditions such as cerebral palsy or Down syndrome may be born with strabismus. Parents and siblings of children with strabismus also have a higher chance of being affected. In this condition, a person looses the ability to direct the right and left eye towards the same direction. This loss of binocularity can disrupt the development of normal vision in a child and create double vi-sion in adults. Many strabismus sufferers are treated during childhood and avoid the impaired vision and discrimination that often accompany the condition.

Consuelo was born with a large angle esotropia, meaning that his left eye turned inward. During surgery last-ing about 90 minutes, Dr. Martin, as-sisted by resident Dr. Michael Hemond, realigned the eyes by moving his eye muscles. Bandaged overnight, he viewed his transformation the next morning. “It was like a dream come true,” he said.

“Now I can see well with both eyes instead of just one, and I can look people straight in the eye instead of looking down or away,” Consuelo says. “Along with my new appearance, the world looks much bigger to me now in more ways than one. I will be forever grateful to Dr. Martin for being so help-ful and kind to me.”

Reconstructing the Eye So Her Inner Beauty Shines Through

At age 19, Christine Nakato, from Uganda, suffered a disfiguring and trau-matizing injury when she was attacked with battery acid. Her left eye was com-pletely destroyed and the left side of her face and body severely burned. A local clinic performed skin grafts to protect her eye, which was little more than basic first aid, not the long-term sophisticated

treatment needed to help her recover her health and appearance.

Her rescue lay with the Grossman Burn Foundation in West Hills which brought her to California for a complex series of treatments that ultimately involved two members of the PVF board. Their skill and compassion effectively changed her life, a combination of philanthropic generosity and the donated services of skilled physicians. Today, at 22, Christine is back home with her 3-year-old daughter and a new life.

This is her story: In July 2015, at the Grossman Burn Center, ophthalmic plastic surgeon, Dr. Mark Baskin, performed eye socket reconstruction surgery. Knowing that she needed an artificial eye, he contacted Steve Young (below), an ocularist who specializes in creating lifelike ocular prostheses who is also a member of the PVF board. Christine’s journey back and forth between Southern and Northern California, was coordi-nated by Marcus Whithorne, Executive Director of the Grossman Burn Foundation, who accompanied her for the various procedures.

Steve Young “is a real master, and so people come from all over the world

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to see him,” Dr. Baskin said. “And being a great person as well, he also agreed to create Christine’s artificial eye for free.”

Because Christine was blind in her left eye, which was covered with skin, there was no space for an artificial eye. Dr. Baskin removed scar tissue and replaced it with a skin graft from the lining of Christine’s mouth; then Young created a customized “conformer,” a molded plastic shell that keeps the eye-ball and eyelid separated after surgery while the eye heals.

About six weeks later, as Young was preparing to remove the conformer to make room for the artificial eye, he discovered that tissue had fused the conformer to her socket requiring a last minute surgery. The issue was resolved by a quick call to fellow board member Dr. Erich Horn, the Chief of Compre-hensive Ophthalmology at California Pacific Medical Center who practices in an office only a block away. Arriving with a scalpel, some surgical scissors and topical anesthetic, Dr. Horn removed the conformer in just a few minutes. “Steve and I are both on CPMC’s faculty,” Dr. Horn explained, “and our physicians are both collaborative and collegial.

For a patient who had come such a long way for a remedy and a colleague who had requested a favor, he said, “I was happy to do this minor procedure at no charge.”

Explaining his work, Young said that he crafted the scleral shell that would fit like an oversized contact lens over Christine’s damaged eye and make her look like herself again. “I begin by study-ing the patient’s intact eye to replicate its appearance as closely as possible in every detail, from the pigments in the iris to the intricate pattern of the blood vessels,” he said. “Then I paint layers of color onto an acrylic disc, cover it with clear plastic to prevent it from getting scratched and polish it with a special buffer.”

Shingles and pneumonia vaccines are now recommended for older adults because the immune system weakens with aging.

Dr. Emmett T. Cunningham Jr., Chief of the Uveitis Service at California Pacific Medical Center, says that people age 50 or older should consider getting both vaccines which appear to be well-tolerated and produce lasting benefits. He advises that “the latest research studies also show that it’s safe to take both vaccines together—so this ounce of prevention is a “two-fer” for your health.”

The virus that causes chicken pox can remain latent in the body and be reactivated as shingles (zoster) later in life, and there is a 30% risk for adults. Shingles involving the eye or eye-lids (herpes zoster ophthalmicus) increases a person’s risk of stroke by four-fold.

Pneumococcal infection can lead to serious complications, resulting in hearing loss, limb loss, brain damage and sometimes death. The majority of healthy adults who are vaccinated become immune to either most or all of 23 types pneumococcal bacteria within two to three weeks of receiving their injection.

Originally reported in EyeNet Magazine, published by the American Academy of Ophthalmology

Ocular Shingles Raises Stroke Risk

Alumni AbroadCPMC Alumni (2009) Dr. Vincent Ray (below) is currently in Liberia supporting the research endeavors of the National Institute of Health (NIH), the National Eye Institute (NEI) and the United States Agency for International Develop- ment (USAID) in their effort to treat and better classify the post-viral ocular syndrome occurring in Ebola survivors. Dr. Ray is running the clinic and research program solo for seven weeks. We can welcome him back to the States on December 18th.

“The happiest I’d seen Christine in months is when she saw her new eye for the first time,” Whithorne recalled. “She cried for sheer joy. It was like she’d gotten back a part of herself that she’d lost.”

He also marveled at the generosity of everyone who had provided care for Christine at no cost. “This is the Gross-man Burn Foundation’s first time coordi-nating with Steve Young and Dr. Horn,” he said, “but it certainly won’t be the last. This was something of a bridge-building exercise that will benefit the Grossman Burn Foundation, PVF and, most impor-tantly, people suffering from eye burns which can have catastrophic effects on their entire lives.”

Link to Grossman Burn Foundation Website: www.grossmanburnfoundation.org

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American Academy of Ophthalmology Honors Dr. Bruce Spivey with 2015 Laureate Recognition Award

In November, the Academy awarded Dr. Spivey the highest honor in American ophthalmology for contribu-tions that “span the profession from educator, clinician, hospital CEO, ophthalmology department Chair and medical society CEO to transforma-tional professional leader.”

In childhood his lifelong commitment to education began when he watched his grandfather sign his name with an “X” because he could neither read nor write. Bruce Spivey was first in his family to graduate from college, going on to medical school, receiving a master’s degree in Ophthalmic Science in 1964 and a master’s degree in Medical Education in 1969.

Highlights of Dr. Spivey’s long career offer a snapshot of achievements that culminated in the Laureate Recognition. At age 31, he was the first Army ophthalmologist to serve in Vietnam, for which he was awarded the Bronze Star, and subsequently he taught ophthalmology at the University of Iowa while conducting clinical research on the genetic causes of strabismus. He became Chief of Ophthalmology at Pacific Presbyterian Medical Center (now California Pacific Medical Center or CPMC) in 1971, serving until 1987, and was the first physician CEO of Pacific Presbyterian Medical Center from 1976 to 1992.

In 1977, Dr. Spivey co-founded Pacific Vision Foundation to develop support for CPMC’s Department of Ophthalmology. More recently he has been central to the development of

the Foundation’s Eye Institute. “When The Eye Institute is up and running, there will be many partners—including CPMC and its renowned Ophthalmol-ogy Residency Program, the Lions Eye Clinic, Smith-Kettlewell Eye Research Institute and the many faculty ophthal-mologists,” said Dr. Spivey. “Patients will receive top-quality ophthalmic care even if they can’t afford to pay.”

Starting in 1976, he also became the founding CEO of the Academy, which position he held for 17 years. Currently he serves as a member of the Board of Trustees of the International Council of Ophthalmology, where he also served as President for eight years and Secretary General for twelve years, spearheading the expansion and improv- ement of ICO’s education, eye care and leadership programs and dramatically increasing its membership base.

As he reflects on the Laureate Recognition award, Dr. Spivey notes “I never learned to say no. It’s all interesting and all a challenge.”

Ellen Jamason (above right), an attorney in Menlo Park, California, has long been active in community service, most recently on the board of Habitat for Humanity Greater San Francisco. When she termed off the board after seven years, including 18 months as chair, Pacific Vision Foundation’s board was a natural fit.

Having worked with PVF as counsel for aspects of the new Eye Institute project, “I was very impressed with the commitment and qualifications of its members,” she said. “I also became particularly interested in the

goal of providing affordable eye care to those of limited means. I find PVF’s aspiration to serve large volumes of patients without regard to their ability to pay inspiring.”

Founder of Jamason Law PC, a boutique law firm focusing on business and real estate, and Managing Director of Common Bond Capital Partners, LLC, a real estate investment firm, Ellen nonetheless has medicine “in my blood.” Her father is a retired primary care physician, her sister an ophthalmologist and her niece a medical student at Stanford. What’s more, she said, “my daughter Marley was certified as an EMT before graduating from college, and is thinking of becoming a nurse practitioner.”

The PVF Board of Directors includes members from the ophthalmology field as well as other areas of expertise who are at the top of their respective professions and bring their special knowledge to the table. Ellen’s extensive set of qualifications also include serving as a partner at two top national law firms and as an

PVF WelcomesNew Board Member, Ellen Jamason

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V I S I O N A R Y L E A D E R S H I Pexecutive at Cisco Systems. Before attending law school, she worked as Deputy Director at the National Security Agency.

With her experience on the Habitat board, Ellen looks forward to contributing to the development of effective fundraising messaging as PVF cultivates philanthropic support to take the organization to a new level with the launching of the Eye Institute. “Habitat was in a period of transformation during my board tenure,” she explained. “We’d set a ten-year strategic vision, and just as we launched it, Governor Brown eliminated the California Redevelopment Agencies, which were our primary source of land and funding. So we had to reinvent the way Habitat did business and delivered services by finding creative solutions to this region’s expensive real estate challenges. We did this by leveraging the innovative mindset of San Francisco and Silicon Valley. The Eye Institute will require the same ingenuity and drive, and I hope to help in that effort.”

New leaders are at the helm of the Department of Ophthalmology at California Pacific Medical Center, and all are closely involved in Pacific Vision Foundation’s mission.

CPMC has announced the appoint-ment of Dr. Kevin Denny (photo on page 3), as Chair of the Department of Ophthalmology for a five year term. For the past year he has served as Acting Chair. He also is Chief of Cataract and Anterior Segment Surgery, with a particular interest in complex cataract

surgery and specialty intraocular lens replacements. A graduate of Harvard College with honors, he received his M.D. degree from New York University and completed both his internship and residency at CPMC. As an alumnus of the program he feels “a special sense of responsibility to give back.” He is an ex officio member of the PVF Board of Directors.

Dr. Erich P. Horn (above) is the newly appointed Vice Chair and also is Chief of Comprehensive Ophthalmology. A graduate of Brown University and Harvard Medical School, he served his internship at Stanford University School of Medicine and was a resident at CPMC from 1996 to 1999. He served as Associate Program Director for the next decade and now practices in Oakland. He is also a member of the PVF Board of Directors. In his new role, he will help expand the department’s capabilities in such areas as telemedicine and other technologies.

Dr. Taliva Martin (photo on page 4) serves as Program Director for ophthalmology residents. A specialist in pediatric ophthalmology, she is a graduate of the University of California, San Francisco, School of Medicine (UCSF). She spent her internship at Loma Linda University Medical Center, her residency at CPMC and also was awarded a fellowship at the University of Michigan Hospitals.

Dr. Edie De Niro (below right with Aravind patient in Madurai, India) is the new Associate Program Director, and will join Dr. Martin in managing the program and developing faculty. A glaucoma specialist who also received her M.D. from UCSF, she served her internship at Kaiser Permanente in San Francisco, and residency at CPMC. She has recently completed a glaucoma fellowship at UC Davis School of Medicine.

CPMC’s Ophthalmology Department, which dates back to 1873, has a long tradition of caring for patients, training residents and fellows, philanthropic and research activities. It is also recognized for its dedication to the community. Since 1959, CPMC has worked with the Lions Eye Foundation to provide free eye surgery and treatment for patients who cannot afford their vision care.

Leaders Poised for a Strong Future

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There Are Many Ways to Support PVF’s Mission

• Annual Gifts – sustain our ongoing programs of treatment, research and education. You may designate your contribution to advance the study of a particular eye disease or condition or make an unrestricted gift to be used where the need is greatest.

• Matching Gifts – through your employer will increase the amount of your gift. Speak with your company representative to see if a gift to PVF qualifies for a corporate match.

• Gifts of Stock – which have appreciated in value and have been owned for a least a year, may be transferred by your broker to PVF’s brokerage account #33L093540 at First Republic Bank, 415-296-5884. Please also call or write us with the details of your gift.

Save Sight and Lives Through Gift Planning – Join the PVF Heritage Society

Make a life-changing difference for children and adults with glaucoma, cataracts, diabetic retinopathy and other eye disorders. Your gift to the Heritage Society can support our mission today or benefit PVF and the Eye Institute in the future.

The “planned gifts” below may suit your financial planning needs and sustain PVF:

Bequests

Gifts of cash, securities, real estate or other assets through a bequest can be accomplished by a simple codicil to your current will or an amendment to your living trust. You also may specify a sum

G I V I N G O P P O R T U N I T I E S

O U R M I S S I O N

Pacific Vision Foundation was founded in 1977 with the mission to prevent blindness and to improve vision for those who see imperfectly by fostering the highest level of eye care for the public. This is to be accomplished through contributing to excellence in patient care, improving eye care education of both medical professionals and the public, and supporting innovative ophthalmic research.

or asset, or designate a percentage of your residuary estate. Among the advan- tages, outright gifts from your estate are entirely free from federal estate taxes.

IRA and Other Retirement Plan Gifts

Maximize the impact of your retirement plan assets—including IRAs, 401(k) plans, 403(b) plans, and TSAs—by designating Pacific Vision Foundation Eye Institute as your primary or secondary beneficiary. These assets will not be subject to estate tax or income tax, so that the entire balance will be preserved for PVF/EI.

Life Income Gifts

• Charitable Gift Annuity – Make a gift and create an income stream for yourself or a loved one through a fixed annuity for life, part of which may be tax-free.

• Charitable Remainder Trust (CRT) – As a meaningful future gift to PVF/EI, a CRT provides income for life or for a specific time frame to your spouse, partner and/or your loved ones. You will receive an immediate tax deduction and pay no capital gains on appreciated assets used to create the CRT.

Regardless of your age or income, the PVF Heritage Society offers several types of planned gifts to consider, and each one provides a meaningful, financially beneficial way to prepare for your future and the future of the PVF Eye Institute and its patients. We are happy to work with you and your tax and legal advisors to structure the type of planned gift that best fits your financial and philanthropic goals. For more information, please contact our Executive Director, Jo Burnett, at job@pacificvisionfoundation.orgor call 415-393-1225.

How to Give:

• Donate Online by going to our website http://pacificvisionfounda tion.org and clicking the “Donate Now” button

• Mail a check or credit card payment details to: Pacific Vision Foundation711 Van Ness Avenue, Suite 450San Francisco, CA 94102

Help Us Provide Superb Eye Care for All and Change Countless Lives With a Gift to the PVF Eye Institute.

Horizon is published twice yearly by the Pacific Vision Foundation, a 501(c)(3) corporation.